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Testing & Examination

State-of-the-Art Equipment

Our medical office is equipped with the latest, state-of-the-art examination, testing and measurement equipment. This enables Dr. Harmon and his staff of experienced professionals to provide you with the best diagnosis and care available.

The Slit Lamp Examination

The slit lamp is a microscope with a high-intensity light source. The slit lamp allows the doctor to examine the various structures within the anterior chamber of your eye under high magnification. With special lenses, the structures in the “back portion of the eye” (vitreous, retina, optic nerve) can also be examined. The term “slit” is used because the beam of light on this device is adjustable (from a wide beam to a thin slit of light), making it possible for the doctor to visualize the various parts of the eye in different ways.

The Visual Field Examination

For the Visual Field exam, the patient sits in front of a concave dome and stares at a central target within the dome. A computer-driven program flashes small lights at different locations within the dome's surface, and the patient presses a button when they small lights in their peripheral vision. Your responses are compared to age-matched controls to determine the presence of defects within the visual field.The test will detect any loss of peripheral vision and provide a map of that loss.

Humphrey Automated Perimeter by Zeiss

Determining and monitoring the visual field are crucial aspects of the detection and management of glaucoma. By monitoring the patient’s visual field, doctors are monitoring whether or not vision is being lost. In glaucoma, it is the peripheral (side) vision that is most commonly affected first. Loss of peripheral vision can go unnoticed at the early stages. In fact, loss of peripheral vision can often go undetected until significant glaucoma damage is present. Currently, the state-of-the-art visual field test is the Humphrey automated perimeter.

Short Wavelength Automated Perimetry (SWAP)

SWAP is performed on the Humphrey visual field machine (perimeter) and is the so-called blue-on-yellow test. This test shows the patient blue stimuli (dots of light) on a yellow background. For a patient to detect these blue dots on a yellow background, specific cells that are usually damaged very early in the development of glaucoma must function. It is these specific cells that are being tested in SWAP. The SWAP test is more sensitive in early glaucoma than late and can detect visual field loss before it would be detected with a standard white –on-white test. It is believed that SWAP may be able to detect visual field loss related to glaucoma as early as 5 years before damage is seen with standard white-on-white perimetry.

The Heidelberg Retinal Tomography (HRT) Examination

The HRT scans a patients eye with a beam of light, producing a topographical or surface image of the eye's optic disc, and then measures the key structures known as the cup, rim and retinal nerve fiber layer. The instrument then stores each patient's images, and on a follow-up visit the device checks for signs of statistical change.The Heidelberg Retina Tomograph 3 (HRT 3) is a confocal laser scanning system for imaging of the anterior and posterior segments of the eye. It comprises three modules which can be used independently or combined with each other. The major routine clinical application is analysis of the optic nerve head structure for glaucoma diagnosis. A second application is in diabetes for the location and quantification of retinal edema. With the Rostock Cornea Module, the HRT 3 is converted into a confocal microscope for in vivo assessment of the cornea and conjunctiva. Worldwide, more than 5.000 HRTs support physicians and optometrists in diagnosis and follow-up. Their experience over time has confirmed the high diagnostic value of HRT examinations, based on highly reproducible measurements. Both 2- and 3-dimensional images are acquired with high resolution and without data interpolation. Built-in quality controls enable the user to evaluate image quality during and after the acquisition. The HRT is a tried-and-tested, versatile technology you can rely on. The new HRT 3 is the single most powerful technology to help you assess, diagnose and manage glaucoma. The new Glaucoma Probability Score (GPS) gives an objective, user-independent, structural assessment of the optic nerve head using artificial intelligence and ethnic-specific databases. Enhanced progression analyses identify and track areas of statistically significant change over time to assess glaucomatous progression. These tools increase physician confidence in detecting real, clinically significant changes in optic nerve head structure.

Optical Coherence Tomography (OCT)

OCT produces cross-sectional images of the retina. This technology allows accurate measurements of the retinal nerve fiber layer, the optic disc, and the macula (the center of the retina and the surrounding area that provide you with the sharpest central vision). OCT is a valuable tool in the evaluation of glaucoma and macular disorders.

IOLMaster

The IOLMaster is used for biometric measurement and preoperative computation of intraocular lens (IOL) power. Non-contact Optical Coherence Biometry revolutionizes measurement of the ocular axis and sets new standards for speed and accuracy. IOLMaster technology makes possible exact measurement of visual axis length. Its accuracy is not affected by high ametropia, pupil size or state of accommodation. The integrated OD/OS sensor eliminates the risk of confusing right and left eye data.

Precise axial length measurements

Non-contact optical biometry

Multiple operators, same measurement results

Improved refractive results through personalized IOL constants

Performance, simplicity, efficiency – the IOLMaster provides all biometric parameters required for IOL power calculation in a natural, user-friendly sequence in a single location

Master-Vu B-Scan

The Master-Vu B-Scan provides unparalleled portability and intuitive operation. Capable of capturing both still images and video clips, the Master-Vu provides excellent image resolution with a full set of features including display of A-scan trace across a selectable vector, near-mid-far gain controls, zoom and pan capabilities, multiple measurement functions, annotation, and more. Usable with laptop, desktop, or tablet PCs, the Master-Vu B-Scan is extremely intuitive and easy to use and has the trusted trademark Sonomed Escalon reliability. Some of the features include: Simple USB connection to most any PC, including tablet touch screen PC’s Captures both still image and video clips with on-probe activation switch Frame-by-frame review of video clips provided for selection of optimal images Selectable simultaneous A-scan vector Easy to use measurement calipers for distance and angle measurements Continuous zoom and pan functions Near-mid-far gain, contrast, and TVG controls for optimal diagnostic capability TheMaster-Vu B-Scan offers extreme portability, and comes with hard-shell padded carrying case, USB cable, and USB memory stick pre-loaded with the Master-Vu software that can be loaded onto multiple computers (three licenses included – contact Sonomed Escalon about obtaining more licenses). A patient database and image library is provided with printing and download capabilities. The proprietary software differentiates the Master-Vu B-Scan as best-in-class of the most portable B-scan available.

CL-200 Computerized Lensmeter

The CL-200 Computerized Lensmeter combines innovative technology with ease-of-use. It features progressive lens measurement, a large color LCD monitor, and a new green light reading beam that enhances measurement precision.

Kocan Non Contact ROBO specular microscope

Since 1947, Konan has been a world leader in innovative optical products, developing the first non-contact specular microscope in 1979. Konan is the pioneer in Specular Microscopy, offering solid innovation for more than 60 years.Why Specular Microscopy? Konan specular microscopes provide cellular level views of the endothelium. Fast, simple, fully-automated, and delegated.Biomicroscopy alone will routinely miss many dystrophies and endothelial problems.

Sonomed PacScan 300A A-Scan

The PacScan 300A is a portable, digital A-scan system which provides easy-to-use touch screen operation. The combination of a high-frequency low noise probe and fast precise algorithm enables scan capture immediately upon application of the probe along the visual axis. The PacScan 300A provides:

Live A-Scan display

Storage of 5 different user profiles

5 different examination modes

Measurement review capability

5 different IOL formulas

Immersion capabilities

Clinical accuracy ± 0.1 mm

The PacScan 300A is portable, weighing less than 6 lbs., and comes with optional padded carrying case. Optional printer allows for hardcopy record of scans and IOL calculations. Two probe styles are also available, depending upon the type of scanning application.

Topcon KR-8800 Auto Refractor / Keratometer

The All-New Topcon KR-8800 Auto Refractor is loaded with new features with proven consistent and accurate results. Now available at a reduced price, the KR-8800 delivers precise accurate objective refraction data with the Topcon exclusive Rotary Prism Technology. Rather than single-measurement points like other auto-refractors, the Rotary Prism covers a wider field, ensuring the most reliable objective refraction data. The KR-8800 offers an all-new color LCD monitor, reduced measurement time, a small 2mm minimum pupil requirement, pupil/cornea diameter measurements, PD measurement, an infra-red reflex feature to monitor developing opacity, and USB and RS-232 connections for enhanced and faster data transfer. The all new KR-8800 automatically acquires the refraction and keratometric data after alignment, making it the perfect choice for todays fast paced practice.

Tono-Pen AVIA® Applanation Tonometer

The award winning Reichert Tono-Pen AVIA tonometer is an easy to use, hand-held instrument that provides IOP readings that correlate strongly with Goldmann tonometry. Tono-Pen AVIA has a lightweight, ergonomic design and advanced electronic measurement technology that enables operators to take fast and accurate IOP measurements with minimal training. Tono-Pen AVIA is powered by a long-life Tono-Pen AVIA POWERCEL battery pack, good for over 2,500 measurements. Tono-Pen AVIA, like the Tono-Pen XL, uses sanitized Ocu-Film tip covers to minimize the risk of patient cross contamination.

Pachmate DGH55

The DGH Technology, Inc. Pachmate (DGH 55) is the ultimate in portable pachymeters. Only 6.9 inches long and 3.6 ounces in weight. The Pachmate is a handheld pachymeter that gives accurate reliable corneal thickness measurements. The Pachmate will easily fit in a lab coat or shirt pocket. The Pachmate is rugged in design and one of the world’s smallest portable pachymeters. Every Pachmate will rapidly store and recall up to 25 measurements bilaterally. The display shows a running average and the standard deviation in microns. The Pachmate can be permanently configured to meet the operator’s requirements Audible feedback indicates both valid measurements and the completion of each measurement group. The Pachmate is designed for aiding in glaucoma screening. When IOP correction is enabled, press and hold the ENT button after obtaining measurements and an IOP correction value will appear on the display.

DGH Model 555 PACHETTE 3

The DGH Model 555 PACHETTE 3 will enable eye care professionals to measure corneal thickness faster and easier utilizing improved ultrasound technology. The PACHETT 3 uses the exact enhanced corneal thickness measuring algorithm used in all the DGH pachymeters used exclusively by the OHTS investigators. The DGH Model 555 PACHETTE 3 is capable of measuring and storing up to 25 measurements bilaterally in as little as 1.6 seconds per eye. The IOP correction calculation is built into the software. The new backlit LCD character displays OD and OS measurements, running average, standard deviation and IOP correction calculation and allows easy visibility from a distance over a large viewing angle, and in all lighting conditions. Portable and lightweight, the PACHETTE 3 weighs only 0 .8 kilograms. Powered by two (2) AA NiMH rechargeable batteries The PACHETTE 3 probe is solid filled and has a clear polystyrene tip only 1.5 mm in diameter for easily visualizing the center of the cornea.The DGH Model 555 PACHETTE 3 is ideal for glaucoma and refractive surgeons, DGH Technology, Inc manufactures ultrasonic measuring devices for cataract and refractive surgeons of the 21st century. Since 1982, DGH Technology has set the standard for measuring corneal thickness around the world.

KI Standard Keratometer

The Marco Keratometer I is a one position instrument for objectively measuring corneal curvature. By simply rotating the Keratometer until a major axis is located, curvatures in both major and minor meridians can readily be measured. The Marco Keratometer assures objective accuracy in such measurements as well as in the fitting of contact lenses. Manufactured with brass and stainless steel moving parts for durability, the Marco Keratometer incorporates such other features as precision objectives, achromatic prisms, and uniform diffuse illumination.

The Lumenis Selecta® Duet™

Breakthrough SLT Technology and a Yag Photodisruptor in ONE PlatformThe Lumenis Selecta® Duet™ represents the industry’s most advanced anteriorsegment laser, combining the advantages of YAG photodisruption capabilities along with the innovative Selective Laser Trabeculoplasty (SLT) technology, which was developed and brought to market by Lumenis.The system’s fully integrated design, enhanced optics and advanced laser cavity make the Duet one of the best performing laser products in its segment.The Duet is also the only upgradeable SLT and YAG combination Laser currently available in the market – allowing you to further extend the unit’s capabilities by adding photocoagulation technology at any point in time.Proprietary Advanced Laser DesignLumenis draws its strength & leadership from over 40 years of ophthalmic laser design and innovation. As the company’s flagship multi-modality product, the Selecta represents the next generation of ophthalmic lasers by capitalizing on numerous proprietary features:

Super Gaussian Beam Profile in YAG ModeThe Selecta features a highly accurate Super Gaussian beam profile in order to achieve optical breakdown – or photo disruption – with the lowest possible energy levels. This feature enhances the Selecta’s safety profile and allows you to perform capsulotomies on all types of intraocular lenses (IOL) with significantly lower risk of lens pitting or potential adversary effects. With the Selecta, you can achieve more efficient tissue cutting at lower power and with fewer shots.

VISULAS YAG III – The New Dimension of Disruption

The Super-Gaussian beam profile ensures that optical breakdown is achieved with very low pulse energies. The result: fewer side effects for the patient and less risk.

Precise: The 4-point aiming beam system facilitates the ability to focus with extreme precision and to detect any astigmatic distortion before firing the laser.

Ergonomic: The design guarantees unobstructed visual contact with the patient and free access to the eye. The control console contains a large illuminated display for menu-guided operation.

VISUCAMNM/FA – The two-in-one Fundus Camera System

Special Autofluorescence (FAF) Option available, not just for fast and easy acquisition of Fundus Auto-Fluorescence images, but ICG angiography as well

Easy to use as a result of cutting edge ergonomic design with novel features such as Auto-Flash and Auto-Focus, which minimize corrective exposure actions performed by the operator.

Small pupil mode for color exposures enables photos with pupil diameters of 3.3 mm, the smallest for any traditional non-mydriatic fundus camera.

Compact design of an all-in-one system – Photograph and evaluate retinal photography on the same device while being able to and send images through any existing network.

Cassini: Total Corneal Astigmatism Analysis System

New York, NY, USA (14 November 2014) - Eye diagnostics innovator i-Optics, announcesthe commercial launch of Cassini Total Corneal Astigmatism functionality designed tomeasure both anterior and posterior astigmatism. Previous clinical studies havedemonstrated that posterior corneal astigmatism could be a factor in generatingunexpected postoperative outcomes.1 With this new functionality, Cassini provides anindividual measurement of the Total Corneal Astigmatism (TCA) for cataract patients. Thiswill help cataract-refractive surgeons to calculate the power and position of Toricintraocular lenses (IOLs) with higher accuracy and help reduce intraoperative andpostoperative surprises.Cassini uses patented multi-colored LED point-to-point ray tracing to provide a GPS-likeanalysis of the cornea along with high-resolution images utilized for surgical guidance.Recent clinical studies have demonstrated the performance of Cassini anterior corneal steepaxis repeatability of less than 3 degrees.2 This capability has led many of the top surgeons inthe USA and International markets to choose Cassini as their preferred corneal diagnosticdevice for refractive-cataract surgery planning.The new Total Corneal Astigmatism functionality uses patented second purkinje reflection-based analysis of the posterior cornea. Cassini posterior and anterior data is calculated toprovide surgeons with the total corneal power, as well as, steep axis and magnitude ofastigmatism. The impact of understanding the relationship between the anterior andposterior of the cornea should help to provide a more customized planning approach tocorrecting astigmatism at the time of cataract surgery. It can also be used to track post-operative outcomes for enhancement procedures and determine surgically inducedastigmatism.

Within a mere second the Pentacam® supplies you with precise diagnostic data on the entire anterior eye segment. The degree of corneal or crystalline lens density is made visible by the light scattering properties of the respective media and is automatically quantified by the software. Measurement of the anterior and posterior corneal surfaces supplies the true total refractive power of the cornea. The data on the posterior surface support in Keratometry for toric IOL calculation and orientation as well as in the detection of early ectatic changes.The rotating scan supplies more data points in the centre of the cornea. A supplementary pupil camera corrects for eye movements during the examination. Unlike conventional topography systems the Pentacam® measures true elevation data rather than just curvature values.